I only found out today that pregnancy is considered a pre-existing condition in the US, which prevents many from getting covered under health insurance. Is this really true? Please enlighten me!
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@Freckles: it differs depending on the policy.
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@Freckles: No that is not true at all. It is only a "pre existing condition" for certain add on insurance like "Aflac"
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Okay, that was the first i ever heard of it so i was so confused. I guess it all depends on the policy/insurer?
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@Freckles: It depends on the circumstances, but yes, if the woman didn't already have insurance and is obtaining insurance (say through a new employer), pregnancy is often considered a pre-existing condition for which a new insurer is not obligated to provide coverage.
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Who told you this? Your insurance company?
Annoying but true story: I told my husband I was pregnant and his first reaction (yes, we were trying to get pregnant) was to have a mini freak out and to call our insurance co to make sure pregnancy was NOT a pre-e condition. It wasn't.
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Some insurance companies consider it a pre-existing condition. So ridiculous!
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@mediagirl: Haha, i'm not American but came across it in an article today (http://well.blogs.nytimes.com/2013/07/08/what-does-birth-cost-hard-to-tell/?ref=health) My question was related to if you were looking for insurance or signing up with a new employer, which @MsLipGloss: answered.
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Generally if are obtaining insurance through an employer, then pregnancy is not a pre-existing condition. If you are trying to obtain insurance coverage outside of your employer, then many policies will not cover pregnancy without an add-on policy, and then only after a certain waiting period.
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@Freckles: ah, gotcha, didn't see Mslipgloss's post until after I posted mine. I'm constantly amazed at how much we in America have to worry about medical coverage and associated costs for things that are just covered in other countries.
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@kiddosc: It can be if you didn't already have coverage . . . like if you were unemployed, as opposed to changing from one job to another.
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@MsLipGloss: I'm not so sure about that bc I confirmed that before risking to go w/o health insurance after I got laid off.
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@MsLipGloss: The way I understand it, HIPAA laws prevent pregnancy from being an exclusionary condition.
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@regberadaisy: This is my understanding . . . but I am no expert!
Under HIPAA, group health plans cannot consider pregnancy a pre-existing condition and cannot exclude coverage for prenatal care or delivery, regardless of your employment or health insurance history, but only if the plan already includes maternity coverage. This is true whether you are the primary insured or a dependent. So, health insurance plans can't deny you coverage when you go from one job to another and switch employer-sponsored group health plans.
Unfortunately, HIPAA applies mainly to group health plans. So if you move from one individual health plan to another individual health plan or from a group plan to an individual plan, you might not get pregnancy coverage at all, you might have to sit out a waiting period, or, if you are offered insurance that covers your pregnancy, you might find it's very expensive.
The Affordable Care Act is supposed to change that. Beginning in 2014, new individual health insurance plans and employer-sponsored plans will not be able to refuse you coverage or charge you higher premiums for being pregnant or having other pre-existing conditions.
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It depends on your insurance coverage. My friend intentionally didn't go to the Dr. to confirm her pregnancy until she signed up for health insurance even though she knew she was pregnant. But I know with Obamacare there are no pre-existing conditions so you can literally call to set up a plan from the emergency room and have your visit covered. Which (I've heard) is why most people are choosing to pay the penalty instead of signing up for the coverage since the penalty only costs about 1/2 of what the premium would cost and there is no incentive to buy it ahead of time as there are no pre-existing condition clauses.
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@MsLipGloss: We are saying the same thing... you just said it more eloquently. Though it does say that if you were unemployed and are hired on to a position with maternity coverage while pregnant, then you cannot be denied benefits.
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